"Breastfeeding is complicated, and most mothers can’t do it.” That’s what this culture has thought for decades. But the more we learn, the more we realize that human newborns are just like every other mammal newborn: They know what to do. The mother doesn’t have to do much or know much. Mothers don’t breastfeed; babies breastfeed. It’s that simple.

But breastfeeding is still complicated, and we’re finally realizing why. Mothers in our culture haven’t given birth since the early part of the 20th century. And no mammal who has birth taken from her goes on to nurse easily, or even to mother easily. It’s not the breastfeeding that’s the problem, it’s the birth!

When a woman goes to a strange place and lies down and is anesthetized for a process designed for an alert, responsive, mobile woman in a familiar place, she increases the risk of a host of complications for both her baby and herself. It’s called a “cascade of interventions.”

Since breastfeeding is really the baby’s job, it’s important that he, too, be awake and aware. Yet all birth medications affect him, some for up to a month. That can mean problems with recognizing and attaching to the breast, problems with suckling well, even problems with bonding. A dizzy, hazy baby needs more help from his mother—help she, and even the hospital staff, may not know how to give. If this results in nipple damage, it happens in a place filled with unfamiliar germs, and her breastfeeding problems may be compounded by thrush or mastitis—another part of the cascade of events.

Today’s women do hard physical labor at gyms, in their yards, and perhaps on the job. No pain, no gain. Would anesthesia help with that kind of labor? No; it would just keep them from doing the job as well. Today’s women understand the notion of strenuous work just as well as their mothers did, and they’re fully equipped for the physical work of having a baby. What they fear, perhaps, is the loss of control that comes with doing an unfamiliar job. And so they offer up all control, becoming spectators at their own births.

But you can do this work! You were born to do it, and you’re built to do it. All the sensations come from your own muscles. And if you’ve ever seen the face of a woman who did the birth herself, completely on her own terms, you can see that it’s one of the highest highs a woman can experience.

UNICEF and the World Health Organization, back in 1990, realized that breastfeeding was doing just fine in places where women birthed at home with midwives; it was in hospitals that breastfeeding was in trouble. No surprise. Take birth away from women, and we take breastfeeding away from babies. Certainly, a mother can get breastfeeding back…but it can be harder and more painful, and much longer than the labor she tried to avoid. Motherhood always involves labor, in one way or another. Take the easy route! Labor before your baby is born, not after.

Epidurals are good hospital management and good business. They keep women in bed, they keep them still, they keep them quiet. They put the hospital staff in total control. And they are profitable: “It’s time for your epidural now” can put an extra $1,000 on the tab.

Giving birth isn’t wildly painful, and you get a break after every contraction, but it’s no walk in the park. Our bodies normally respond by producing endorphins that help block the pain. Being born is no walk in the park, either. The endorphins circulating through the mother’s bloodstream help block the baby’s pain as well. No labor pain means no endorphins—and so the baby’s discomfort increases. No endorphins in our milk means he can’t find the same comfort there, either. At the moment of birth, we produce oxytocin and may feel “the ecstasy of birth.” Oxytocin helps us fall instantly in love with our babies. Without the feeling of giving birth and without these normal hormones, the experience is flat, as if it happened to someone else, as if that baby isn’t really, truly ours. That’s why other mammal mothers tend to reject any baby born after a medicated birth in a strange place.

Giving birth on her back turns a woman into a patient when she deserves to feel—yes, during labor— like a queen. The baby’s pressure on large blood vessels affects blood pressure for both of them. Her pelvis can’t expand normally, so she’s more likely to feel pain during birth and afterward. Her baby doesn’t descend and rotate properly, requiring tugging and turning that can leave the baby in pain as well. Birth works best when the mother keeps full control of the process.

Having a long epidural can involve the liquid equivalent of at least 14 cans of soda. The excess fluid swells a woman’s face, fingers, ankles, breasts, and nipples, making breastfeeding all the more difficult. It can also slow down her milk, resulting in jaundice and supplements for the baby, both of which increase the risk of early weaning.

Don’t let them kid you: Having an epidural hurts. This is not novocaine; half of your body goes numb. Normally, a woman adjusts her position automatically. She labors standing, squatting, on one hip, on her hands and knees. The position that feels the best works the best. The woman who can’t feel takes pot luck…and takes the episiotomy that likely goes along with it. (Did you ever wonder why a woman would need an episiotomy for a 5-pound baby? It’s not the baby, and it’s not the woman. It’s the anti-gravity “epidural position.”)

The point of all this is not to scare you. It’s to remind you that bringing a baby into the world and caring for it involves work, no matter how you look at it. You can labor during the birth, or you can labor afterward. But no one who has enjoyed a good birth would trade it for a spectator sport. Lactation consultants who also teach birth relaxation techniques find that their clients don’t generally overlap; mothers who kept control of their births find their babies can usually take care of the breastfeeding.

If you want a birth that will be a joy to remember all your life instead of something that you and your baby need to recover from, you have some work to do. Ask your childbirth instructor for some good books on birthing without medications. You’re going to surprise yourself!